Specific Learning Difficulties and Intellectual Disabilities, Identification, Support, and Prevention

UPI Study › Courses › Abnormal Psychology › Free lessons › Lesson 21.5 Free with a free account

Specific Learning Difficulties and Intellectual Disabilities, Identification, Support, and Prevention

Abnormal Psychology · Chapter 21: Developmental Disorders Across the LifespanSection 21.5 · lesson 83 of 9720 min · free with a free account

← Defiant and Conduct-Related Behavior Disorders, Behavioral StrategiesNext lesson: What Are Personality Disorders? A Broad Introduction →

Earn 3 college credits for Abnormal PsychologyRecommended for credit by NCCRS · Psychology 180 · self-paced · one payment, lifetime access
Enroll in Abnormal Psychology · $250 →Download the syllabus (PDF)

In this lesson

Identification, support needs, rights - and the question that prevents overshadowing.

  • Describe specific learning disorder, and how it is identified
  • Explain why it reflects neither intelligence nor effort
  • Describe intellectual disability by adaptive functioning and support needs
  • Apply rights-based support, and avoid diagnostic overshadowing

Transcript

Everything said in the video, section by section (2,567 words). Read along, or search it.

Developmental Disorders Across the Lifespan

Learning Disorders and Intellectual Disability

This final section of chapter twenty-one covers specific learning difficulties, and intellectual disabilities. How they are identified, supported, and prevented. We describe specific learning disorder, how it is identified, and why it reflects neither intelligence nor effort. Then intellectual disability, defined by adaptive functioning and support needs, its history, and the rights frameworks that followed. And the question that prevents diagnostic overshadowing. Two composite cases close the section.

Before You Begin

Terminology and What's Left Out

This material is educational, and not a basis for diagnosing anyone. Assessment in both areas requires qualified professionals, using procedures that reading cannot replace. On terminology. Historical clinical terms for intellectual disability, and the slurs derived from them, are not used or reproduced here. They were clinical categories that passed into everyday use as insults. Their continued use, even in casual speech, harms people who hear themselves described that way. The current term is intellectual disability. And no test scores, cut-offs, or instruments appear in this section. Severity is described by support needs, which is what is clinically and educationally meaningful.

Specific Learning Disorder

Persistent Difficulty Despite Good Teaching

In paraphrase, specific learning disorder involves persistent difficulty learning and using academic skills, continuing despite intervention targeting those difficulties. The affected skills are substantially below what is expected for the person's age, and interfere with academic or occupational functioning. The difficulties begin during the school years, though they may not become fully apparent until demands exceed capacity. And they are not better explained by intellectual disability, uncorrected vision or hearing, other conditions, psychosocial adversity, or lack of proficiency in the language of instruction. Or by inadequate instruction. That final exclusion does substantial work, and we will come back to it.

Table 21.5.1

3 Specifiers - Each With Avoidance

Three specifiers describe which skills are affected. Reading involves word accuracy, fluency, and comprehension. In class, decoding is slow and effortful, reading aloud is avoided, and comprehension is better when material is heard than read. Support is explicit phonological instruction, text-to-speech, and extra time. Written expression involves spelling, grammar, and organization. There is a large gap between what the pupil can say and what they can write. Support includes planning frames, speech-to-text, and assessing content separately from handwriting and spelling. Mathematics involves number sense, arithmetic facts, and calculation. Number facts do not stick despite practice, and multi-step procedures break down. Support is explicit instruction, concrete before abstract, and calculation aids where reasoning is what is assessed. Notice that every row contains a form of avoidance. Avoidance is often what brings the child to attention, and it is often misread as a behavior problem.

Reading Difficulty

Sound Structure, Not Reversed Letters

The leading explanation of reading difficulty is the phonological processing account. Reading an alphabetic script means mapping written symbols onto the sounds of spoken language. That requires perceiving, holding, and manipulating those sounds, hearing that a word is made of separable sounds. Difficulty with that underlying processing makes the mapping hard to acquire. Early phonological measures predict later reading, and instruction targeting phonological skills improves outcomes. The popular belief that reading difficulty is a visual problem of reversed letters needs correcting. All young children reverse letters when learning to write. The core difficulty is with sound, not sight. That matters, because the visual myth directs attention toward interventions without evidence, and away from the structured phonological instruction that works. And a specific learning disorder is not a reflection of intelligence or effort. A child may reason well in discussion, understand complex material heard aloud, and be unable to read the text describing it. A child who works hard and fails publicly, and is told they are not trying, forms a conclusion about themselves. The academic difficulty is remediable. The conclusion often outlasts it.

Table 21.5.2

2 Ways to Identify

Two approaches to identification are used. The discrepancy model identifies a substantial gap between measured general ability and achievement. But it required waiting for failure large enough to produce a gap, the wait to fail problem. And disadvantaged children, whose measured ability had been depressed by circumstance, did not show the gap, and were not identified. Response to intervention identifies inadequate response to good, increasingly intensive instruction, monitored over time. It identifies difficulty earlier, and delivers support during identification. But it depends entirely on the quality of that instruction. The most practically important point is that inadequate instruction must be excluded first. A child who has not been taught to read effectively, will present exactly like a child with a specific learning disorder. Telling them apart requires knowing what instruction was actually delivered, which is information about the school, not the child.

Co-Occurrence, Support, Adulthood

Remove the Barrier, Keep the Standard

ADHD co-occurs frequently, and the two compound each other. Language disorder often precedes reading difficulty. And anxiety arising from academic failure is extremely common, and often the presenting complaint. Note the direction. The anxiety follows the academic difficulty. Treating it without addressing the learning need treats the consequence, and leaves the cause. Support means explicit, systematic, intensive instruction in the specific skill. Discovery-based approaches perform less well for these learners, which is among the more consistent findings here. Accommodations and modifications are different, and often confused. An accommodation changes how a learner accesses material or shows learning, leaving the standard intact, like text-to-speech or extra time. A modification changes what is expected. Using a modification where an accommodation would do lowers expectations unnecessarily. And assistive technology is often transformative, yet withheld as a shortcut, which mistakes an access barrier for the thing being assessed. In adulthood, the difficulty persists, usually with substantial compensation. And outcome depends heavily on identification and support, rather than on severity alone.

Intellectual Disability

Defined by Adaptive Functioning, Not a Score

In paraphrase, intellectual disability involves deficits in intellectual functioning, meaning reasoning, problem-solving, planning, abstract thinking, judgment, and learning, confirmed by clinical assessment and individual testing. It also involves deficits in adaptive functioning, failing to meet developmental and sociocultural standards for independence and social responsibility, with onset in the developmental period. The most important change in understanding is the shift away from score-based definition. Earlier approaches defined it mainly by a score below a threshold. The current definition requires both intellectual and adaptive functioning, and severity is set by adaptive functioning, not by score. The reasoning is simple. Two people with similar measured functioning may need entirely different support, depending on what they can do in daily life. And support is what services actually provide.

Table 21.5.3

3 Adaptive Domains, Described as Support

Adaptive functioning is assessed across three domains. The conceptual domain covers language, reading, money, time, and memory in everyday tasks, like managing a budget or understanding an appointment letter. The social domain covers interpersonal skills, social judgment, friendships, and recognizing when a situation or person is unsafe. The practical domain covers personal care, work skills, health care, and travel, like getting to work or attending health appointments. Notice that every entry in the final column describes support, not deficit. What a person needs help with is actionable. A description of what they cannot do is not. Levels are conventionally named as needing intermittent, limited, extensive, or pervasive support. A level describes the support needed at a point in time, and changes with age and environment. And a level is never a description of a person. Saying that someone is severe replaces a person with a category.

Causes

Often, No Specific Cause Is Found

Causes include genetic conditions, named here only by category. Chromosomal conditions, single-gene conditions, and copy-number variation. Prenatal and perinatal factors include prenatal exposures, infection, and complications around birth. Acquired causes include early childhood infection, injury, and environmental toxins. A specific cause is not identified in a substantial proportion of cases. That should be said plainly to families, who often expect an answer assessment cannot give. And alongside it, say that not knowing the cause does not change what support is needed. Global developmental delay is a provisional category for young children not yet old enough for reliable assessment, who show marked delay across areas. It is explicitly provisional, and reassessed.

History

Documented Harm - and Why Rights Frameworks Exist

The history of intellectual disability includes documented harm on a large scale. It is presented factually, because it shapes today's rights frameworks, and today's distrust of services. Institutionalization placed large numbers of people in institutions, often from childhood, far from their families, and for life. Conditions were often extremely poor, and the institution added its own harm. Sterilization was carried out without meaningful consent in many countries during the twentieth century, under laws that in some places stayed in force for decades. And intellectual disability was a central target of eugenic movements, which sought to stop people having children, and in the most extreme cases extended to murder. This history is documented, and it is not distant. So distrust of services has a documented basis. And all three practices rested on the assumption that decisions are better made for people than by them. That is the assumption supported decision-making exists to reverse.

Rights and Current Frameworks

Supported, Not Substituted, Decisions

The framing premise is this. People with intellectual disability have the same rights, preferences, and capacity for relationships and meaningful life as anyone. That is not a sentiment. It is what current frameworks are built on. Deinstitutionalization moved provision toward community living. The principle was right, though the community provision meant to follow was often underfunded. Self-advocacy, people speaking for themselves and organizing collectively, is now central. Supported decision-making is replacing substituted decision-making, and the difference is fundamental. Substituted decision-making appoints someone to decide for a person judged unable. Supported decision-making gives whatever help the person needs to make and communicate their own decision, like accessible information, more time, or a trusted supporter. It rests on a presumption of capacity. A person is assumed able to decide unless shown otherwise, one decision at a time. And an unwise decision is not evidence of incapacity.

Diagnostic Overshadowing

A Change Is Never Explained by a Lifelong Disability

Mental health conditions occur at higher rates in people with intellectual disability, and they are frequently missed. Diagnostic overshadowing is the main reason. A change in behavior, withdrawal, or poor sleep is recorded as part of the disability, rather than as a change needing explanation. And the treatable condition producing it goes untreated. The avoidance is a habit. Ask whether this is a change. A lifelong disability explains a lifelong characteristic, and never a new development. Establish and record a baseline, so future changes can be detected. Investigate physical causes, including pain, which is often missed in people who cannot easily report it. Adapt the assessment rather than abandoning it, with simpler language, more time, concrete questions, visual supports, and information from people who know the person well. And beware the reverse error. Attributing everything to a mental health condition, and nothing to boredom, loss, a change of staff, or an unmet need, misses just as much.

Figure 21.5.5

The Same Presentation, Assessed 2 Ways

Here is overshadowing, in one picture. Both panels start with the same presentation. A person with intellectual disability who has become withdrawn, sleeps poorly, and is tearful. On the left, it is put down to the disability. And a treatable condition is missed. On the right, someone asks one question. Is this a change, and since when? And the condition is found, and treated. That single question is the whole of what separates a missed treatable condition from a treated one.

Communication and Support

Talk With the Person, Plan Around Their Goals

Communicating with a person, rather than about them, is a basic competency that is breached constantly. Address the person directly. Speaking to the supporter about the person, while the person is present, is the most common failure, and the person notices immediately. Adjust complexity, not tone. Simpler language and shorter sentences are appropriate. A voice used for small children is not, and adults experience it as demeaning. Allow processing time, and do not fill the pause. Ask one thing at a time, and check understanding by asking what the person understood, not whether they understood. Use their communication method, and find it out beforehand. Support is planned around the person. Person-centered planning is organized around their own goals and preferences, with them present and participating. Skills are taught if the person wants them, in the settings where they will be used. Supported employment helps people into ordinary paid work. And families are supported in their own right. A plan built on what a service offers, rather than what a person wants, is a timetable, not a plan.

Education, Prevention, Aging, Safeguarding

Across the Lifespan

A few final points across the lifespan. In education, the inclusion debate has real arguments on both sides, and the binary is unhelpful. An unsupported mainstream placement may serve a person worse than a well-resourced specialist one. Transition into adulthood is consistently the weakest point. Prevention here means public health measures only, like maternal and child health care, nutrition, immunization, injury prevention, and reducing lead exposure. Nothing here bears on whether particular people should exist. Life expectancy has risen substantially, a real achievement, though a gap remains. People with some genetic conditions have elevated rates of dementia, with earlier onset. Recognizing decline requires knowing the person's baseline, so a baseline assessment in adulthood, before any decline, is what makes later recognition possible. And people with intellectual disability experience abuse and exploitation at elevated rates. Responding is a professional duty. They are also less likely to be believed when they report it, which is a professional failing, not a feature of the situation.

Case Vignette 1 (Composite)

Jonah: A Reading Difficulty Blamed on Effort

Now two composite cases, constructed for instruction. Jonah is eleven. For years, his school described him as bright but not applying himself. He was late to talk, loved being read to, and learned to read slowly from the start. He is now well behind in reading and spelling, increasingly reluctant to attend, anxious before literacy lessons, and has told his mother he is the stupid one. He had two years of small-group literacy support with limited progress, so the exclusion for inadequate instruction has been addressed. His hearing, vision, and language of instruction were checked. And his reasoning, with material read aloud, is strong. The gap between what he understands when material is read to him, and what he can get from print, is the characteristic profile. It also explains why teachers called him bright. He was, in every context that did not require reading. His anxiety is secondary to the reading difficulty, and will not resolve if treated as a primary anxiety condition. So he receives intensive phonological instruction, text-to-speech and extra time, and assessment of content separate from spelling. And explicit work with him and his parents on what this is not. It is not about intelligence, or effort.

Case Vignette 2 (Composite)

Deborah: Initially Overshadowed

Deborah is twenty-nine. She has an intellectual disability, with support needs in the practical and conceptual domains, and lives in supported accommodation. Staff reported that she had become withdrawn, was sleeping poorly, had stopped an activity she had enjoyed for years, and was tearful. It was recorded as part of her disability, with no further assessment. That is diagnostic overshadowing exactly. Everything reported was a change, and a lifelong disability does not explain a change. It explains her baseline, and nothing about the past three months. Physical causes, including pain, were assessed first. Her baseline came from staff who had known her for years, and from her sister. And the assessment was adapted, so that when she was asked directly and accessibly, she could give her own account. She was experiencing a depressive episode, following losses. A long-standing staff member had left, and a close relative had died the previous year. Nobody had connected either to the change, and nobody had asked her about them. Her depression was treated, and her circumstances were addressed too, the loss of a familiar person, and the drop in activity. So ask whether this is a change, and since when. Record a baseline. Check for pain. Adapt the assessment. And ask the person directly.

About Abnormal Psychology at UPI Study

Abnormal Psychology (Psychology 180) is a self-paced online course of 97 video lessons in 25 chapters, from the main theoretical perspectives and clinical assessment to anxiety, mood, psychotic and personality disorders, treatment and the law. It carries a NCCRS credit recommendation for 3 semester credits.

Every lesson transcript is free on pages like this one, and the videos are free with a free UPI Study account. Enrolling adds a practice quiz after each lesson, the graded work and final exam that earn the credit, lifetime access, and an official transcript on completion. UPI Study has helped over 130,000 students with college credits. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.

Enroll now → Course details Download the syllabus All Psychology and social science courses Every course with PRO →

Why take it here

Why students take Abnormal Psychology with UPI Study

Understand mental health disordersAbnormal Psychology covers how psychological disorders are defined, assessed, explained and treated. It is a core course for psychology majors and useful for nursing, social work, counseling and criminal justice.
Credit at a fraction of the priceThe same 3 credits can cost $750 or more at a US college. Here it is one payment, self-paced, with lifetime access.
Finish your degree soonerTransfer credits reduce the courses you still owe, so you can graduate earlier or lighten a heavy semester.
Strengthen an applicationA completed college-level course on an official transcript shows admissions and scholarship committees you can do the work.
Study on your own scheduleNo start dates, no deadlines. Watch the lessons, practice, and take the final when you are ready.
130,000+students helped with college creditsACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.

Where the credit goes

Universities that work with NCCRS

Abnormal Psychology carries a NCCRS credit recommendation. These universities work with NCCRS; some are UPI Study's signed partners. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.

Thomas Edison State UniversityThomas Edison State UniversitySigned partnerUniversity of the PeopleUniversity of the PeopleSigned partnerCharter Oak State CollegeCharter Oak State CollegeSigned partnerStrayer UniversityStrayer UniversitySigned partnerColumbia Southern UniversityColumbia Southern UniversitySigned partnerIndiana TechIndiana TechSigned partnerPenn StatePenn StateWorks with NCCRSSouthern New Hampshire UniversitySouthern New Hampshire UniversityWorks with NCCRSSUNYSUNYWorks with NCCRS +many more cooperating universitiesFind my college →

Find my college → Not listed? Ask Athena in the corner of this page, or book a 15-minute call.

FAQ

Questions students ask us

About Specific Learning Difficulties and Intellectual Disabilities, Identification, Support, and Prevention

Is dyslexia a visual problem of reversing letters?
No, the leading explanation of reading difficulty is phonological, not visual. Reading requires mapping written symbols onto the sounds of spoken language, and difficulty perceiving and manipulating those sounds makes that mapping hard to learn. All young children reverse letters while learning to write. The visual myth matters because it steers families toward unproven interventions and away from structured phonological instruction, which has evidence.
What is the difference between the discrepancy model and response to intervention?
The discrepancy model identifies a learning disorder from a large gap between measured ability and achievement, while response to intervention identifies inadequate progress under good, increasingly intensive instruction. The discrepancy model meant waiting for failure and missed disadvantaged children whose measured ability was depressed. Response to intervention finds difficulty earlier and supports the child meanwhile, but it depends entirely on the quality of the instruction.
What is the difference between an accommodation and a modification for students with learning disabilities?
An accommodation changes how a learner accesses material or shows learning while keeping the standard the same, such as text-to-speech or extra time. A modification changes what the learner is expected to do. The two are often confused, and using a modification when an accommodation would work lowers expectations unnecessarily. Assistive technology is an accommodation that removes an access barrier rather than giving an unfair shortcut.
What is diagnostic overshadowing in intellectual disability?
Diagnostic overshadowing happens when a new symptom, such as withdrawal, poor sleep or tearfulness, is put down to a person's intellectual disability instead of being investigated. A treatable condition like depression or pain then goes untreated. The key question is whether the behavior is a change, and since when, because a lifelong disability explains lifelong characteristics, not new ones. Recording a baseline makes later changes easier to detect.

About the Abnormal Psychology course

How many college credits is Abnormal Psychology?
Abnormal Psychology (Psychology 180) carries a NCCRS credit recommendation for 3 semester credits. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.
How much does Abnormal Psychology cost and what is included?
$250, paid once, with lifetime access: all 97 video lessons, a practice quiz after each, the graded work and final exam, and an official transcript when you finish. Students who want several courses choose UPI Study PRO instead.
Which universities accept UPI Study credits?
UPI Study has signed partner agreements with universities such as Thomas Edison State University, University of the People and Charter Oak State College, and works with universities such as Penn State, SNHU and SUNY. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities. Use "Find my college" on this page to check yours.
How long does Abnormal Psychology take?
It is self-paced with no deadlines. The 97 lessons total about 24 hours of video; most students add reading and practice time and finish in a few weeks to a few months, on their own schedule.
How are the exams done?
Quizzes and assignments are online in the course. The final exam is taken online with proctoring; a person on the UPI Study team checks assignments, usually within two days.
How do my credits reach my college?
When the course shows 100% complete, request the official transcript from your dashboard. It is sent to the college you name, and you can send it to more than one. Check your college first with "Find my college" on this page, or ask Athena.

Ready for the full course? Earn 3 credits in Abnormal Psychology.

97 video lessons, a quiz after each one, and the graded work that earns the credit. Recommended for credit by NCCRS.

Enroll in Abnormal Psychology →Download the syllabusEvery course with PRO →
Abnormal Psychology
3 credits · NCCRSEnroll →